Socioeconomic status and the risk for colonisation or infection with priority bacterial pathogens: a global evidence map

Abstract

Low socioeconomic status likely exacerbates risks for bacterial infections; however, global evidence for this relationship has not been synthesised. We systematically reviewed the existing literature for studies detailing the socioeconomic status of participants and their risk for colonisation or community-acquired infection with priority bacterial pathogens that are increasingly becoming antibiotic resistant. 50 studies from 14 countries reported outcomes by the participants' educational attainment, access to health care, income level, residential crowding status, socioeconomic status deprivation score, community setting, or access to clean water, sanitation, and hygiene. Low educational attainment, lower than average income levels, inadequate access to health care, presence of residential crowding, and high socioeconomic status deprivation scores were generally associated with elevated risks of colonisation or infection. Limited research has been conducted on these outcomes in low-income and middle-income countries, and findings regarding the effects of community settings (eg, urban vs rural) on these outcomes have been conflicting. Only a proportion of studies focused on pathogen colonisation and infection yielded data stratified by the socioeconomic status of participants. Stratified data should be included in future research to enhance understanding of the complex relationship between socioeconomic status and health, particularly in low-income and middle-income countries.